Building a framework for growth

Northeast Home Medical Equipment was Medforce’s first customer, and has remained a loyal client for well over a decade. With Medforce’s document management and workflow automation systems in place, the company successfully navigated several mergers and acquisitions and has grown by over 150%.

Challenges

Northeast Home Medical Equipment is part of the St. Peter’s Health Partners, a Hospital system which encompasses four hospitals, three rehab centers, and home care and infusion services and over 12,000 employees. In business since 2001, an acquisition forced Northeast HME to merge with another Durable Medical Equipment (DME) company that left billing and records management in a state of upheaval.

It was an elaborate process to bring the companies together. They did not have a unified billing system and had to manually review and authorize every single patient to continue billing. Stacks of paper were everywhere, and it was difficult to find what was needed, often having to check across five different desks to find a file. Certificates of Medical Necessity (CMNs) needed to be revised to reflect the new provider name - a tedious process to be repeated many times over, but critical to securing payment. And, with a large hospice contract, the company was bringing on new patients and closing out accounts at a fairly fast rate. Keeping up with the paperwork was a challenge.

One of the biggest issues in the DME industry is getting paid and staying paid, through successfully managing paperwork and responding appropriately to audits. Even with the merger aside, Northeast HME was further challenged by tracking medical documentation, specifically the justification for the delivery of equipment to patients through prescriptions and CMNs. Doctors are located outside of Northeast HME and billing was done by a third party. Northeast needed an efficient way to manage documentation requests and ensure the paperwork was transmitted to their billing company timely.

Knowing that more acquisitions and growth within the health system was imminent, the company felt urgency to get the office in order. It was not only critical for the daily need of getting reimbursed in a reasonable timeframe, it was essential for building a foundation for future growth. This prompted Northeast HME to look to outside firms for document management, and brought the company to Medforce.

I absolutely love Medforce and stand behind it 110%. I’ve been a part of many different software installations and by far it was the easiest conversion I’ve ever been a part of. It was just phenomenal. So many people have been burned by complex software makes it difficult for staff to adapt. [Medforce] is so intuitive. Everything I need is at my fingertips.

— Irene Magee, VP Northeast Home Medical

Solution

Northeast started with their biggest pain point – patient records. Implementing ContentCenter’s document management capabilities meant all patient files could be stored centrally and accessed by anyone. After a half-day of on-site training, Northeast made the decision that all new work would get scanned and stored in the Medforce system. Then, they slowly worked backward through all outstanding AR, and scanned those complete files. Soon all current, active patients and any new ones were in the system.

Today, if there is a question about any patient, the record can be brought up on screen and staff can see the entire order history– what was ordered, what was delivered, when it was delivered, and how many deliveries were made. When audits come up, there is no longer frantic searching for the file or loose paper. All documentation is available in an organized, standardized, and accessible manner.

After the success of going paperless, Northeast began to look for other ways to systematize and streamline operations. They instituted Medforce’s CommandCenter product to track the status of medical documentation requests and to ensure claims wouldn’t be filed without the necessary back up. There are many different ways to get complete documentation from physicians –fax requests, phone calls, go to the hospital with batches, or communicate one-on-one with physicians. Using CommandCenter enables a complete, real-time view into the status of these requests, regardless of the method of outreach, and nothing can fall through the cracks.

By giving their billing company access to the CommandCenter system productivity has improved even further. Northeast has been able to easily communicate about and manage denial reasons, missing documentation, QA reviews, and audit requests. It’s a seamless transfer of data between the company and their billers.

Results

Since implementing ContentCenter and CommandCenter, Northeast Home Medical has achieved impressive growth while maintaining a lean operation. Their health system has merged twice, rapidly growing demand. They now have the dominant market share in the region. Because of the efficient operations and software in place Northeast has been able to keep up with a greater workload while growing staff at less than the growth rate.

Since implementing Medforce:

Overall staff have grown from 15 to 43, but Northeast has reduced filing staff from 1 full time employee to a staff member who scans for 2 hours a day

Even with increase in documentation burden due to growth as well as regulation changes, medical documentation requests are handled by an employee for fewer than 2 hours a day

All totaled, it’s about 0.5 FTE handling medical documentation

The company freed up a room that used to contain 12 full sized filing cabinets to use as office space for their growing staff